The WHO and IPCRG in a joint webinar call for health professionals to be leaders and role models to help reduce tobacco use in 2021
The focus of the 2021 year long World No Tobacco Day (WNTD) campaign is quitting tobacco. WHO has called for bold and transformative steps which are needed to encourage and support tobacco users worldwide to quit tobacco use. IPCRG joined the WHO tobacco team to deliver a webinar on June 16th 2021 that described how health professionals can support the objective of at least 100 million tobacco users becoming empowered with the necessary knowledge and have access to tools to make a quit attempt.
At this webinar we heard first from Rüdiger Krech, Director WHO Health Promotion Department who reminded us that during the COVID-19 pandemic smokers and former smokers were more likely to experience worse outcomes, counteracting the surprising and misleading early pandemic data that suggested possible protection. He explained that 60% of tobacco users want to quit but only 30% will have access to the necessary evidenced based interventions that exist.
Commit to Quit - Roles and actions for health care professionals
Dr Kerstin Schotte, WHO spoke further about the EIGHT roles and actions for health professionals. You can hear her talk more about being a
- Be a role Model - Quit tobacco,
- Make recording of tobacco use routine, make asking routine
- Be an educator and help new generations to be ready to help people quit
- Be a researcher and use evidence based interventions and consider tobacco users in all health outcome trials
- Be a leader and influence policy, start small and make your own clinic smoke free
- Be an opinion leader, work with media and policy makers
- Build alliances
- Stop the tobacco industry - be a watchdog and don't accept funding.
The Quitter Diaries
One of the WHO resources “The Quitter Diaries” are video stories of six people from each WHO region and their experience of using tobacco and quitting. They provide great tips and the stories demonstrates why primary care is important in helping people with their quit plan.
How clinicians and other health professionals can provide brief tobacco interventions as part of their treatment routines and daily practice
We heard from our IPCRG colleague and Professor of Family Medicine Katarina Stavric from North Macedonia where they have the highest prevalence of tobacco use in Europe with 46% of adults smoking. They have some limited specialist centres for helping people quit but these reach small numbers and so they have worked to support family medicine physicians to reach more people and make a difference to a range of health outcomes. An important lesson was that primary care physicians didn’t have the confidence in or knowledge of how to deliver the behavioural change and prescribing interventions. They have carried out a RCT looking at whether carbon monoxide and lung age tests can help people make a successful quit attempt. We look to seeing the final results and will report them here. They have learned a lot from qualitative work on patient and health professionals beliefs and attitudes and will continue to work in this area. Much focus is now on medical students in North Macedonia as part of the role modelling approach described by the WHO.
Noel Baxter shared the Ottawa whole system integrated model for tobacco use identification, treatment and follow up and how this has had impacts on 30 day and 1 year outcomes on health care use and mortality. Case studies and examples were shared that have relevance to day to day primary care practice.
Dr Dongbo Fu, WHO shared more resources available for health professionals focusing on evidence based tools that enable us to provide brief advice and make it part of every health consultation. He highlighted the WHO e-Learning course for primary care providers in brief tobacco interventions which is free and available in English, French and Chinese.
The importance of medicines in treating tobacco dependency
Ioanna Tsiligianni ended the webinar with a discussion about the importance of medicines in treating tobacco dependency. She described that essential medicines are those that satisfy the health priorities of a population and are available in adequate amounts at a price that people of usual income in a community can afford. 160 governments use the essential medicines list (EML) however this does not always mean that the medicines are available on national formularies. In 2009, nicotine replacement therapy - gums ( short acting) and patches ( long acting) where added to the EML and there are applications to build on this to provide varenicline, cytisine and more forms of nicotine replacement to ensure people have the most clinically and cost effective options, and a range of options to try. She highlighted how in both India and Greece cost and availability is a problem despite both countries supporting the EML model. Sadly most countries do not support tobacco users to quit by having the right medicines.